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American Heart Month 2015: Avoid Silent Heart Attacks By Practicing Prevention Now, While You're Still Young

February is devoted to raising heart-health awareness, and you don't have to be of a certain age to pay attention. When it comes to heart disease, prevention is everything. Mykl Roventine/CC BY-NC-SA 2.0

Real life heart attacks aren’t like what you see in the movies. There isn’t an exaggerated clutch of the chest or an exaggerated fall. Sure, plenty of attacks are evident, but there are those that aren’t.

We’re talking about silent heart attacks (SHA). Both men and women aren’t diagnosed until they start to experience signs and symptoms of a heart attack, heart failure, an arrhythmia, or stroke, reported the Centers For Disease Control and Prevention. These symptoms often linger and are hard to pin-point, thus the reason so many sufferers dismiss them as something else, like stress. A 2012 JAMA study found SHAs are more common in older adults between the ages of 67 and 93 — and they’re equally deadly.

But 40-year-old Jen Thorson, a Go Red For Women national volunteer, was only 37 when she suffered an SHA. She told Medical Daily she would’ve thought she was a healthy person. She was training for her second marathon, eating relatively well, and frankly, didn’t consider herself at-risk at all — even with her family’s history of high cholesterol and heart disease. It was during marathon training in August 2011 she noticed her work outs were getting harder rather than easier. So she pushed herself to work even harder. A few days later she started feeling terrible pain in her back, but instead of going to the doctor, she chalked it up to heartburn from her spicy dinner.

She didn’t consider a heart attack until she researched her symptoms online. Given the immediate cold sweat she broke out in, Thorson decided to go to the ER. And since her family has a history of heart disease, doctors performed an electrocardiogram (EKG) right away; she passed. Next came an echocardiogram, an x-ray, even a CT scan and she passed those too. Thorson was in the ER for 10 hours before doctors performed a cardia catheterization, otherwise known as a coronary angiogram.

An angiogram involves doctors running a catheter into the heart in order to see what’s going on. Thorson’s test showed high levels of troponin, the proteins integral to muscle contraction in skeletal and cardiac muscle. The levels increase as a sort-of reaction to heart trauma, and when her numbers were elevated, Thorson was finally admitted. In fact, her circumflex artery had been 100 percent blocked — something doctors would have missed if not for this particular test.

“A cardiologist told me I didn’t fit the profile of someone having a heart attack, which is just classic—a classic line,” Thorson said.

Doctors simply saw a young and fit woman in front of them, so it was hard for them to consider heart attack. While Thorson bounced back quick after being admitted, a year later she narrowly missed a second SHA; she called her doctor the minute she started feeling her same back pain.

“The thing I didn’t know would be the hardest is that heart disease is a chronic and progressive illness. It’s one thing to have a heart attack and survive it, and it’s another to have a chronic illness. The two get conflated when it comes to heart attack. I now have some limits on my life,” Thorson said. “It’s the quality of life issues I want women to understand: you’re not going to get better. It’s going to stay with you. The time to make changes is not after — it’s now. Prevention is everything.”

A Heart-Healthy Lifestyle

February is American Heart Month — and with the help of their Go Red campaign, the American Heart Association will strive to educate women on these silent symptoms, as well as their differing symptoms from men among other things; yes, men and women experience heart attack and stroke in different ways. But like Thorson said, when it comes to heart-health, the focus should be on prevention. This goes for both men and women, especially young adults, Go Red cardiologist Dr. Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital, told Medical Daily.

“This is a time in life when habits are firmly established, because this is a time young adults become independent. They develop lifestyles and habits they’ll carry on [as they get older],” she said. “I’m going through this myself with my son who is 25. He just moved to Colorado, is building his own house, and he’s very interested in his long-term habits, like learning to cook healthy meals. [This age] is a good time to do a self-assessment.”

Regular physical activity, a varied diet (though more fruits and vegetables), limiting fast and processed foods, as well as red meat are heart-healthy factors everyone should consider; they prevent common risk factors for heart disease, like high blood pressure. Another factor is sleep, Mosca said. Chronic insomnia, for instance, has been linked to high BP. In addition, scientists have found ties between health problems and a lack of adequate sleep.

“Risk factors can creep up on you,” Mosca said. “People gain weight steadily after they turn 18. We frequently see an increase of 10-pounds per year after graduating high school.”

More importantly, everyone should work on developing a great relationship with their primary-care physician. A physician will help you to better understand your family’s health history, the symptoms and signs of heart disease and heart attack, as well as the preventive measures you can take to prevent disease. Pregnant women in particular may have a lot to learn.

For the first time ever, the AHA’s effectiveness-based guidelines for the prevention of cardiovascular disease in women focuses on pregnancy-related risk factors. Until now, women and physicians were both unaware of certain things pregnancy could reveal about future risk for heart disease. Conditions, such as preeclampsia, high BP, gestational diabetes, and pre-term delivery lead to a two-fold increase in heart disease risk, Mosca said. If pregnant women develop any of these conditions, they’ll know going forward it’s time for pre-emptive action.

Make Some Noise

Putting your health first is another lesson Thorson’s heart disease taught her. People in the habit of putting others ahead of themselves struggle with this selfishness, but taking care of your own self is taking care of your friends and family.

“It’s been three-and-a-half years since my first heart attack and I’ve grown, progressed, and learned to understand my illness. Now, I’m about making noise,” she said. “I’m about gender equality in research and treatment and making sure all women know they fit the profile. You can advocate for yourself.”

Thorson will participate in the AHA’s nationwide campaign this month, doing media rounds and participating in local health fairs. On Friday, Feb. 6, she’ll participate in National Wear Red day both on- and offline. Thorson invites her friends and family to send her pictures of them in red, including the reason why they’re showing their support. You have to say the why in order to spread the word, she said.

Public health campaigns rolled out over social media are scrutinized for their efficacy; an article in the British Medical Journal reported only one percent of peer-reviewed papers that looked at the impact of marketing campaigns assessed behavioral, rather than attitudinal changes. That may be, but Thorson believes social media is what’s going to accelerate the movement for increased heart-health and prevention. The Go Red campaign itself has managed women’s awareness 30 to 50 percent in the 11 years since it began.

“I think we’re going to see a big acceleration with social media in part to how easy it is to connect with like-minded individuals,” Thorson said. I’m really energized for the big picture and big change.”